Malignant Struma Ovarii: An Autopsy Report of a Clinically Unsuspected Tumor

Ribeiro‐Silva, Alfredo; Bezerra, Alanna Mara Pinheiro Sobreira; Serafini, Luciano Neder

doi:10.1006/gyno.2002.6816

Cited by 20 publications

(3 citation statements)

References 8 publications

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“…The most common secondary tumor is squamous cell carcinoma, corresponding to up to 80% of such neoplasms, but several malignancies have already been reported, including adenocarcinomas, adenosquamous carcinomas, undifferentiated carcinomas, sarcomas, carcinosarcomas, and melanomas [1,14,16,17,24,30]. Other neoplasms arising in teratomas include carcinoid tumors, thyroidtype tumors, and neuroectodermal tumors [3,12,22,25]. There are only five undisputed reports of sebaceous carcinomas arising in benign teratomas of the ovary since the case reported by Tsuchiya et al was reclassified by Chumas and Scully as "basal cell carcinoma with sebaceous differentiation" [5,6,9,21,26,29].…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological and immunohistochemical features of a sebaceous carcinoma arising within a benign dermoid cyst of the ovary

Ribeiro‐Silva

Chang

Bisson³

et al. 2003

Virchows Archiv

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Pure sebaceous neoplasms arising in dermoid cysts of the ovary are exceedingly rare. A 63-year-old female with abdominal swelling and pain underwent a right salpingo-oophorectomy that showed a unilocular cyst weighing 830 g and measuring 15x12x10 cm, filled with sebaceous material containing a few hair shafts. The cyst wall exhibited plaques protruding into the cavity of the cyst. Microscopy revealed a dermoid cyst with nests and lobules of atypical and infiltrating sebaceous cells surrounded by basaloid cells. The tumor cells stained diffusely for high-molecular-weight cytokeratins and focally for cytokeratin 7, cytokeratin 19, epithelial membrane antigen and carcinoembryonic antigen in the immunohistochemistry study. Low-molecular-weight cytokeratins, cytokeratin 20, vimentin, S100, p63, estrogen receptor, progesterone receptor, p53 and c-erbB-2 were negative in tumoral cells. The proliferative labeling index (Ki67 and proliferating cell nuclear antigen) was low. Basal cell carcinoma with sebaceous differentiation and sebaceoma must be considered in the differential diagnosis. However, the presence of obvious malignant sebaceous differentiation in nearly every tumor nest and lack of peripheral palisading and peri-tumoral myxoid stroma excluded these diagnoses. Some histogenetic concepts relevant to this case are discussed along with a brief review of this neoplasm. To our knowledge, this is the sixth case report of a sebaceous carcinoma arising in a mature cystic teratoma of the ovary.

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Section: Discussionmentioning

confidence: 99%

Clinicopathological and immunohistochemical features of a sebaceous carcinoma arising within a benign dermoid cyst of the ovary

Ribeiro‐Silva

Chang

Bisson³

et al. 2003

Virchows Archiv

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“…Struma ovariirelated thyrotoxicosis has been reported even after treatment of a thyroid toxic adenoma (45). Papillary carcinoma has also been described either as an incidental finding (48) or with metastases to the lungs and pleura (49).…”

Section: Other Sitesmentioning

confidence: 99%

Ectopic thyroid tissue: anatomical, clinical, and surgical implications of a rare entity

Noussios

Anagnostis²,

Goulis³

et al. 2011

European Journal of Endocrinology

325

429

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Ectopic thyroid tissue is a rare entity resulting from developmental defects at early stages of thyroid gland embryogenesis, during its passage from the floor of the primitive foregut to its final pre-tracheal position. It is frequently found around the course of the thyroglossal duct or laterally in the neck, as well as in distant places such as the mediastinum and the subdiaphragmatic organs. Although most cases are asymptomatic, symptoms related to tumor size and its relationship with surrounding tissues may also appear. Any disease affecting the thyroid gland may also involve the ectopic thyroid, including malignancy. The clinician must distinguish between ectopic thyroid and metastatic deposits emerging from an orthotopic gland, as well as other benign or malignant masses. Thyroid scintigraphy plays the most important role in diagnosing ectopy, but ultrasonography contributes as well. In cases of symptomatic disease, surgery is the treatment of choice, followed by radioiodine ablation and levothyroxine suppression therapy in more refractory cases. This review provides current understanding about the wide clinical spectrum of this rare condition, also referring to optimal diagnostic approach, differential diagnosis, and management strategies.

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“…Among the few case reports on MSO with pulmonary metastases reported so far (7)(8)(9)(10)(11), most representing papillary thyroid carcinoma arising in MSO. Only 1 patient represented follicular thyroid carcinoma of MSO with bone and pulmonary metastases (11) and did not respond to multidiscipline treatments as well as our patient.…”

Section: Discussionmentioning

confidence: 97%

Missed Initial Diagnosis of Malignant Struma Ovarii Containing Follicular Thyroid Carcinoma

Cong

Chen

et al. 2015

International Journal of Gynecological Pathology

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Distant metastasis of rare malignant struma ovarii (MSO) has been reported for cases associated with papillary thyroid cancer but few with follicular thyroid cancer. A 38-yr-old woman with struma ovarii that was initially diagnosed as "benign" presented with pulmonary metastasis and coughing 17 yr later. The lungs lesions were confirmed to be follicular thyroid cancer by biopsy. Rereview of the initial surgical ovary specimens confirmed the condition to be MSO with follicular thyroid cancer. The patient was treated with total thyroidectomy, which showed no thyroid malignancy, followed by (131)I (iodine-131) treatments. Dramatic reduction was observed in both the stimulated thyroglobulin level and the size of the pulmonary metastases over 1 yr. During the following 3-yr follow-up, the patient remained clinically well, with undetectable thyroglobulin (<1 ng/mL) and small stable pulmonary lesions. This is an exceedingly rare case of MSO with follicular thyroid cancer metastasized to the lungs presenting with a late onset but a fortunate excellent response to multidiscipline treatments. It is advisable that struma ovarii be carefully examined to avoid missing malignancy and patients be clinically followed up even with a benign initial diagnosis.

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Malignant Struma Ovarii: An Autopsy Report of a Clinically Unsuspected Tumor

Cited by 20 publications

References 8 publications

Clinicopathological and immunohistochemical features of a sebaceous carcinoma arising within a benign dermoid cyst of the ovary

Clinicopathological and immunohistochemical features of a sebaceous carcinoma arising within a benign dermoid cyst of the ovary

Ectopic thyroid tissue: anatomical, clinical, and surgical implications of a rare entity

Missed Initial Diagnosis of Malignant Struma Ovarii Containing Follicular Thyroid Carcinoma

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